Dermatology (To Be Sorted) Flashcards
What are causes of desquemating rash
kawasakiscarlet fever - as rash fades
What is the rash associated with Scarlet fever?
Sandpaperblanches with pressurealong flexor creases - anticubital, axillary, inguinal -Pastia LinesDesquemation as rash fades
if you have a baby with intractable severe seborrheic dermatitis, what should you consider as alt Dx
Histiocytosis
how do you treat seborrjeic dermatitis?
frequent washingcan apply vaseline to soften itsoft brush to brush offcan try ketoconazole shampoo or cream twice a week for 2 weeks
baby has a raise, dark brown oval area on their leg. Some hairs are noted to be present. Dx and mgnt
Congenital melanocytic Neviremove in puberty bc of melanoma risk
what is the risk of melanoma in child with giant melanocytic nevi
2-10%recommend sx
if you have a baby with multiple hemamgiomas, wha investigation should you do?
AUS to look for liver hemangiomas
what are risk factors for hemangiomas
femaleprematurelow BWmultiple gestation
by what age shoul an hemagioma grow until?
12 monthplateau phase 12-18 moregression 18m to 9-10 yrs50% have lasting skin changes
what % of children will have residual skin changes post hemagioma?
50%
when do you worry about hemagiomas
periorbitalbeard areamid -linelarge segment of face - think PHACES syndromemultiples - inc risk of liver hemangiomaulcerating
what do you call a port wine stain
nevus flammeus - vascular malformation10% risk of sturge weber if in V1 distribution + glaucoma risklifelong BM
Features of langerhan histiocytosis
DIRecurrent rashBone lesions
what are the criteria for NF1
need 2 or more: CAFE SPOTCafé au lait spots- >6 (>5mm in prebubertal, >15 post)Axillary freckling or inguinalFibromatosis - 2 or 1 plexiform neurofibromaEye- Lisch nodulesSkeletal abn-dysplasia of sphenoid bone or dysplasia or thinning of long bone cortexPositive family historyOptic Tumor
what is the management of vitiligo?
strong topical steroids
how do you differentiate post inflammatory hypopigmentation vs pityriasis alba
very similarpityriasis alba will have a scale
what is pityriasis alba and how do we manage it?
eczema that causes hipopigmentationtreat with 1% hydrocortisone BID for 5-7 days
in what age group is tinea vesicolor more likely to occur?
teen because need the sebum to survive
how do you treat tinea vesicolor?
antifungal shampoo daily for 1-2 weeks
how do we manage staph scalded skin
pain mgntIV clox+/- clindamycin as anti-toxincompresses to heal skin
what is a distinctive feature of eczema herpeticum?
monomorphous rash
how do you manage eczema herpeticum?
confirm Dx via PCR- if unwell - IV acyclovir- if well, PO acyclovir for 10 days-if near the eyes, need optho assessment
what is the treatement for tinea Capitis
Itraconazole as per CPSPO terbinafine for 2-8 weeks
what are side effects to terbinafine
inc LFTdecreased PMNtates alterationsuggest LFT before treatment
How do you treat tinea corporis
TOPICAL - ketoconazole-clotrimazole- terbinafineNOT nystatin
What drugs are usually responsible for SJS/TEN
AEDPenicillinsulpha
what is the diff between SJS and TENS
SJS if 30%
How do we manage SJS?
IV IG x3 d + all supportive stuff
what is the choice of Rx for facial eczema
1% hydrocortisone
What is the initial treatment for limb/trunk eczema?
0.05% betamathsone valerate
What infection can precede the onset of psoriasis
GASespecially guttate pattern
How do you manage psoriasis?
20% - UV, systemic treatmentmost have spontaneous remission weeks to months
who might get neonatal lupus
if mom has anit-Ro and or Anti-Lamom does not need to be symptomaticappears up to 6 weeksresolves by 6 mo
what infection can cause Toxic epidermal necrolysis?
mycoplasma
what type of rsh might occur 2-6 weeks after starting an AED?
mobilliform drug eruptionreoccurs with repeated exposureusually only affects the skin
what is drug hypersensitivity syndrome
mobilliform rash and either: (>1)feverpharyngitishigh LFTLNEosinophilia
how do you manage drug hypersensitivity?
discontinue drugconsider alt Rxanihistaminetopical steroidif severe- oral
what are the important characteristics of urticaria?
wheal are due to transient dermal edema each lesion
how do you manage chronic urticaria?
- eliminate allergen if known2. Allergy testing if not known3. epi pen may be necessary4. antihistamine5 avoid potential triggers - NSAIDS, Alcohol, codeine, physical
At what point can you use Tacrolimus for atopic dermatitis
if > 2 yrsif failed or cannot tolerate steroids
how do you manage alopecia areata?
disease education -variable and recurrent,no preventiontreatment is to control (not Cure)can try potent topical steroids or mid pot injected steroidsscreen for other AI disordersWigscounselling
what are the topical acne treatment options?
RetinoidsBenzoyl peroxideTopical AbxCombo
if the acne is mostly comedomal, what is the treatment option
Retinoid + BP
if the acne is inflammatory, what are the treatment options
BP orTopical Abx + BPcan use all 3…
what is important for a patient to know if they are about to start Isotretinoin
course is 6 mo90-95% will clear after 1st coursewill cause mB dryingTeratogenic - need to be on OCPNeed baseline BHCG and LFTS
if a lesion is stroked and urticaria occurs, what do you call that and when is it useful?
Darier’s signto show mastocytomasusually congenital or seen in early infancy
how do you manage mastocytomas or urticaria pigmentosa?
1.discuss possible triggers - warm bath, contact, exercise, scratching,meds2.Aniti-histmaines3. rarely need epipen4.Resolves by adolescence
what systemic features can be found with urticaria pigmentosa
- FTT2.Chronic diarrhea3. flushing4. HA
what nevus is at risk of BCC
nevus sebaceoustherefore should get excised
what are features of erythema toxicum?
onset 24-48 hrspeak DOL 2resolves by one weekmacules, papules, pustuleseosinophils on smear
if smear shoes eosinophils, what baby rash is it?
erythema toxicum
if smear shows PMNs, what baby rash is it?
transient neonatal pustular melanosis
baby presents with pustules and no erythema, ruptured pustules with peripheral scale and hyperpigmented macules. Baby is otherwise well. Dx
transient neonatal pustular melanosisunknown etiologypresent at birth!!!PMNs on smearno Rx
how do you manage seborrheic dermatitis
1% hydrocortisone powder in antifungal cream
pseudoporphyria drugs
NSAIDSlasixcyclospretinoidstetracycline
what are causes of erythema multiforme
HSV 1stMycoplasma
